title: Laparoscopic partial nephrectomy: An experience in 227 cases.
abstract: OBJECTIVE
  To evaluate our long-term experience with laparoscopic partial nephrectomy (LPN) and to review the literature.
  
  
  METHODS
  We performed a retrospective chart review, evaluating 227 consecutives laparoscopic partial nephrectomies performed between June 1995 and June 2010. Perioperative were recorded along with clinical a oncological outcomes.
  
  
  RESULTS
  Mean age was 56.4 years (18-87) and clinical stages were T1a, T1b and T2 in 90.74% (206/227), 7.48% (17/227) and 1.76% (4/227), respectively. Median blood loss was 250 mL (10-1800). The mean operative time was 108.42 minutes (30-240) and median warm ischemia time was 25 minutes (10-60). The intraoperative complication rate was 2.64% (6/227), 5 (2.2%) secondary to bleeding. The postoperative complication rate was 5.72% (13/227) and bleeding is also the most frequent in 3% (7/227) of the cases. According to the Clavien classification, 1.32% (3/227), 0.88% (2/227) and 3.52% (8/227) were grade I, II and IIIb, respectively. The mean hospital stay was 3.66 days (1-12). Clear cell carcinoma was the most common histological finding in 74.6% (150 patients). TNM clasification was T1a, T1b y T2 in 90.74% (206/227), 7.48% (17/227) and 1,76% (4/227), respectively. No conversion or mortality was reported. Positive surgical margins were found in 4 patients (2.7%), with no local recurrence after long-term follow-up. At a mean follow up of 27 months, one patient had port site and peritoneal recurrence.
  
  
  CONCLUSIONS
  Laparoscopic partial nephrectomy is a safe and viable alternative to open partial nephrectomy, providing equivalent oncologic outcomes and comparable morbidity to the traditional approach in experienced centers.
authors.affiliation: Departamento de Urología y Centro de Cirugía Robótica, Clínica Indisa, Santiago, Chile; Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile. Electronic address: octavio.castillo@indisa.cl.
authors.forename: O A
authors.initials: OA
authors.lastname: Castillo
authors.affiliation: Departamento de Urología y Centro de Cirugía Robótica, Clínica Indisa, Santiago, Chile.
authors.forename: G
authors.initials: G
authors.lastname: López-Fontana
authors.affiliation: Departamento de Urología y Centro de Cirugía Robótica, Clínica Indisa, Santiago, Chile.
authors.forename: I
authors.initials: I
authors.lastname: Vidal-Mora
authors.affiliation: Departamento de Urología y Centro de Cirugía Robótica, Clínica Indisa, Santiago, Chile.
authors.forename: E
authors.initials: E
authors.lastname: Alemán
authors.affiliation: Departamento de Urología y Centro de Cirugía Robótica, Clínica Indisa, Santiago, Chile.
authors.forename: G
authors.initials: G
authors.lastname: Aranguren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Carcinoma renal; Cirugía conservadora de nefronas; Laparoscopia; Laparoscopic surgery; Nefrectomía parcial; Nephron-sparing surgery; Partial nephrectomy; Renal cell carcinoma